MS. BETH ANN PENDERGRAPH (P.A.) – Medical Physician Assistant, NPI 1881723682
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,431 PHYSICIAN ASSISTANT in GA
Provider Addresses for MS. BETH ANN PENDERGRAPH (P.A.)
127 COVE HOLLOW RD
FORTSON, GA 318084353
Phone: (678) 462-1977
Type: Mailing
1805 VERNON RD
SUITE B
LAGRANGE, GA 302403871
Phone: (706) 884-2691
Fax: (706) 845-7314
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-03-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140303001344 | I | Physician Assistant | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J1030 | Injection, methylprednisolone acetate, 40 mg | 230 | 83 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 161 | 79 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 69 | 57 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 46 | 34 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 42 | 34 | $0 |
Insurance plans in this area (ZIP 31808)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | CA | |
| Internal Medicine | GA | |
| Physician Assistant | FL | |
| Interventional Radiology, Diagnostic Radiology | KY | |
| Anesthesiology Assistant | GA | |
| - | CA | |
| D E R M A T O L O G Y | GA | |
| Interventional Radiology, Diagnostic Radiology | NC | |
| Physician Assistant | GA | |
| - | GA |
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